Remote Utilization Management Specialist (RN/SW) – MT

Logan Health; United States; Remote; USD 52,000 - 75,000; Full time

Benefits offered by this job

Four day work week

Affordable medical benefits

401(k) with employer match

Fitness center membership discount

Nursing culture focused on quality

Job summary

Logan Health is seeking a Utilization Management Specialist to join our dedicated team. You’ll review admissions across the Logan Health system, collaborate with physicians, case management, and insurers to ensure appropriate authorization and medical necessity.

This role emphasizes strong communication, clinical judgment, and bedside-to-ballot coordination. The position offers a four 10-hour shift schedule, remote work with Montana residency, and a competitive benefits package.

Qualifications

• Current Montana RN license or multi-state compact license to practice in Montana.
• Bachelor’s degree in Social Work.
• Minimum of five (5) years’ acute care hospital experience.
• CCM Certification preferred.
• Excellent interpersonal and communication skills.

Responsibilities

• Review daily inpatient and observation admissions across the Logan Health system.
• Evaluate physician documentation and patient data to determine admission status.
• Reassess patients to ensure criteria for level of care are met.
• Collaborate with physicians, case management, and insurers for authorizations and reviews.
• Assist with peer-to-peer physician reviews and coordinated care transitions.
• Document UM processes and communicate with stakeholders to resolve issues.

Skills

RN license

Social Work degree

Acute care experience

Communication skills

Education

Associates degree

Bachelor’s degree preferred

Job description

Logan Health is seeking a Utilization Management Specialist to join our dedicated team. You’ll review admissions across the Logan Health system, collaborate with physicians, case management, and insurers to ensure appropriate authorization and medical necessity.

This role emphasizes strong communication, clinical judgment, and bedside-to-ballot coordination. The position offers a four 10-hour shift schedule, remote work with Montana residency, and a competitive benefits package.